The role of human papillomavirus on the prognosis and treatment of oropharyngeal carcinoma

Cancer Metastasis Rev. 2017 Sep;36(3):449-461. doi: 10.1007/s10555-017-9686-9.


Human papillomavirus positive oropharyngeal cancer (HPV-positive OPC) is a distinct subtype of head and neck carcinoma (HNC) distinguished from HPV-negative HNC by its risk factor profile, clinical behavior, and molecular biology. Compared to HPV-negative HNC, HPV-positive OPC exhibits significantly better prognosis and an enhanced response to treatment. Recognition of the survival benefit of HPV-positive tumors has led to therapeutic de-intensification strategies aiming to mitigate treatment-related toxicities while maintaining high response rates. In this review, we summarize key aspects of oral HPV infection and the molecular mechanisms of HPV-related carcinogenesis. We review the clinical and molecular characteristics of HPV-positive OPC that contribute to its improved prognosis compared to HPV-negative HNC. We also discuss current and emerging treatment strategies, emphasizing potential mechanisms of treatment sensitivity and the role of therapeutic de-intensification in HPV-positive OPC. Lastly, we examine literature on the management and prognosis of recurrent/metastatic HPV-positive OPC with a focus on the role of salvage surgery in its management.

Keywords: Head and neck; Human papillomavirus; Oropharynx; Prognosis; Squamous cell carcinoma.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / therapy
  • Carcinoma, Squamous Cell / virology
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / therapy
  • Head and Neck Neoplasms / virology
  • Humans
  • Oropharyngeal Neoplasms / diagnosis
  • Oropharyngeal Neoplasms / therapy*
  • Oropharyngeal Neoplasms / virology*
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / physiopathology*
  • Papillomavirus Infections / virology
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck